Aetiology of donation-related health outcomes

This theme of research aims to identify and understand molecular and biological determinants of potential adverse health consequences of blood donation. The rationale is to determine the causal health consequences of blood donation (and the risk factors for these health outcomes) to lay foundations for novel prevention strategies. These aims will be achieved through analysis of INTERVAL study data, genetic studies of causality (“Mendelian randomisation”) and cohort studies enabled by linkage of donor records to health outcomes data in electronic records. Theme 2 will feed into Theme 3 by identifying risk factors to be used as biomarkers in personalising donation strategies to maximise donor health and the blood supply.

Results from the COMPARE study, which is researching different methods for measuring haemoglobin (iron) levels in blood, will help inform Theme 2.

Projects currently being undertaken by colleagues at the University of Cambridge, the University of Oxford and the Wellcome Sanger Institute:

  • Methods to screen whole blood donors for haemoglobin status
  • Genetic risk factors for restless legs syndrome
  • Determinants of donation-related adverse outcomes
  • Aetiology of iron homeostasis
  • Prevention of vasovagal reactions in blood donors


Theme 2 is led by Professor Emanuele Di Angelantonio, University of Cambridge.

Emanuele Di Angelantonio
Steven Bell
Elias Allara







Research staff: Dr Steven Bell

Trainee: Elias Allara



BTRU in Organ Donation and Transplantation

Canadian Blood Services

Danish Blood Donor Study

deCODE genetics

NIHR BioResource

NIHR Cambridge Biomedical Research Centre

Recipient Epidemiology and Donor Evaluation Study-III (REDS-III)

UK Biobank


Large-scale clinical studies (INTERVAL and COMPARE), plus contributions from collaborators, have yielded an enormous amount of data that can be mined and linked to electronic health records. This will enable investigators to better understand what is happening in the body post-blood donation, which could inform how often a donor should give blood. This information may improve the donor’s experience. In addition, it may reduce the number of deferrals (temporary rejection from giving further donations), which can de-motivate individuals from future donations and directly or indirectly increase the cost of collecting blood.


Didriksen M, et al. Restless legs syndrome is associated with major comorbidities in a population of Danish blood donorsSleep Med. 2018 May; 45:124-131.

O’Keeffe LM, et al. Medium and long-term health risks in living kidney donors: a systematic review and meta-analysisAnnals of Internal Medicine. 2018 Feb 20; 168(4):276-284.

Di Angelantonio E, et al. Efficiency and safety of varying the frequency of whole blood donation (INTERVAL): a randomised trial of 45 000 donorsLancet. 2017 Nov 25; 390(10110):2360-2371.

Schormair B, et al. Identification of novel risk loci for restless legs syndrome in genome-wide association studies in individuals of European ancestry: a meta-analysisLancet Neurol. 2017 Nov; 16(11):898-907.

Goldman M, et al. Comparison of donor and general population demographics over time: a BEST Collaborative group studyTransfusion. 2017 Oct; 57(10):2469-2476.

Harrison JM, et al. Respiratory and hemodynamic contributions to emotion-related pre-syncopal vasovagal symptomsBiological Psychology. 2017 April 26; 127:46-52.